Prognostic Value of PET-Derived Myocardial Flow Reserve in Patients With Very High Coronary Artery Calcium Score.

Background: Coronary artery calcium (CAC) is a strong predictor of cardiovascular outcomes, with patients having high CAC experiencing event rates similar to those in secondary prevention populations. Emerging evidence suggests that patients with extremely high CAC (≥1000) represent a distinct high-risk group. Therefore, this study aims to evaluate the prognostic value of myocardial flow reserve (MFR) in patients with very high CAC.

Management of Cardiovascular Implantable Electronic Device Infection Utilizing a Multidisciplinary Team: A Retrospective Cohort Study.

Background: Significant numbers of cardiac implantable electronic devices are placed in the United States, and infection can be a severe consequence of implantation. Despite guideline recommendations and data demonstrating that lead extraction improves mortality for patients with device infection, rates of lead removal are lower than guideline recommendations. We report the outcomes associated with management of suspected cardiac implantable electronic device infections by a multidisciplinary team.

Evaluation of the 2023 Duke-International Society of Cardiovascular Infectious Diseases Criteria in a Multicenter Cohort of Patients With Intravenous Drug Use: A Retrospective Study.

Background: Intravenous drug use (IVDU) significantly increases the risk of infective endocarditis (IE). This study evaluates the 2023 Duke-International Society of Cardiovascular Infectious Diseases (ISCVID) criteria for diagnosing IE in patients with a history of IVDU.

Methods: This multicenter retrospective study evaluates these criteria in a cohort of 205 patients with intravenous drug use (IVDU) history, comparing outcomes with the 2000 modified Duke criteria.

Management of isolated native tricuspid valve infective endocarditis by a multidisciplinary program: a single-center retrospective cohort study.

Background: Isolated native tricuspid valve infective endocarditis remains a challenging disease to treat given the large number of patients with substance use disorder. There is limited data on the optimal treatment strategy and the impact of a multidisciplinary endocarditis program on outcomes for this population.

Objectives: To assess the clinical outcomes associated with management of native tricuspid valve infective endocarditis by a multidisciplinary team.

Post cardiac arrest left ventricular ejection fraction associated with survival to discharge.

Background: Post cardiac arrest left ventricular ejection fraction (LVEF) is routinely assessed, but the implications of this are unknown. This study aimed to assess the association between post cardiac arrest LVEF and survival to hospital discharge.

Methods: In this retrospective cohort study, all in-hospital and out of hospital cardiac arrests at our tertiary care center between January 2012 and September 2015 were included.

Comparison of Medical Therapy, Valve Surgery, and Percutaneous Mechanical Aspiration for Tricuspid Valve Infective Endocarditis.

Background: The opioid pandemic, and particularly injection drug use, has led to an increase in cases of tricuspid valve infective endocarditis. Indications for valve surgery in right-sided infective endocarditis are not well-defined. Percutaneous mechanical aspiration is considered an alternative in patients at high risk for re-infection of a prosthetic valve but lacks robust outcomes data.

Beyond a team: The comprehensive interdisciplinary endocarditis program in the United States.

Although multidisciplinary teams have been shown to decrease in-hospital mortality for patient with infectious endocarditis, most studies have focused on the inpatient role of these teams, and are primarily based at European tertiary care centers. There is limited literature available on the optimal longitudinal care of this patient population. Here we outline our experience developing an interdisciplinary endocarditis program at the University of Kentucky, which cares for patients from their index hospitalization into the outpatient setting, while also coordinating transfers from regional hospitals and offering education to regional providers.

The Evolving Trends in Infective Endocarditis and Determinants of Mortality: a 10-year Experience From a Tertiary Care Epicenter.

The epidemiology of infective endocarditis (IE) continues to evolve in areas affected by the opioid epidemic. Understanding the demographics of the disease allows us to better tailor therapy towards this at-risk population. This was an observational study of adults (age ≥ 18) admitted to the University of Kentucky hospital with IE between January 2009 and December 2018.

The utility of beta-hydroxybutyrate in detecting myocardial glucose uptake suppression in patients undergoing inflammatory [18F]-FDG PET studies.

Purpose: We evaluated whether serum beta-hydroxybutyrate (BHB) can identify adequate suppression of the left ventricle (LV) among patients undergoing [18F]-fluorodeoxyglucose positron emission tomography ([18F]-FDG PET) for cardiac inflammatory/infectious studies.

Methods: Consecutive patients who underwent [18F]-FDG PET imaging were included. Serum BHB levels were measured in all patients on the day of imaging prior to injecting [18F]-FDG.

Autologous CD133 + Cells and Laser Revascularization in patients with severe Ischemic Cardiomyopathy.

Objective: We tested the hypothesis that targeted TMLR combined with intramyocardial injection of autologous CD 133 progenitor cells is safe and feasible in patients with chronic ischemic cardiomyopathy (ICM) and no revascularization options.

Methods: Eight male patients (age 62 ± 2.4 years) with multivessel severe ischemic heart disease and no revascularization options were enrolled.

Sex differences in machine learning computed tomography-derived fractional flow reserve.

Coronary computed tomography angiography (CCTA) derived machine learning fractional flow reserve (ML-FFR) can assess the hemodynamic significance of coronary artery stenoses. We aimed to assess sex differences in the association of ML-FFR and incident cardiovascular outcomes. We studied a retrospective cohort of consecutive patients who underwent clinically indicated CCTA and single photon emission computed tomography (SPECT).

P2Y12 Inhibitors versus Aspirin Monotherapy for Long-term Secondary Prevention of Atherosclerotic Cardiovascular Disease Events: A Systematic Review and Meta-analysis.

Patients with established atherosclerotic cardiovascular disease (ASCVD) need long-term antiplatelet therapy to decrease the risk of future ASCVD events. We searched PubMed, Cochrane Library, and ClinicalTrials.gov (inception through September 2021) for randomized controlled trials (RCTs) evaluating P2Y inhibitors vs aspirin for secondary prevention of ASCVD events.

Diagnostic Accuracy of FDG PET for the Identification of Vascular Graft Infection.

Background: Fluorodeoxyglucose (FDG) positron emission tomography (FDG PET/CT) can be used to identify and localize infection in patients with vascular graft infections (VGI). We aimed to evaluate the diagnostic accuracy of 18F-FDG PET/CT by defining thresholds for standardized uptake value (SUV) and tissue-to-background ratio (TBR) that would accurately identify the presence of vascular graft infection.

Methods: Patients with suspected VGI were prospectively recruited and underwent 18F-FDG PET/CT scans.

Inflammatory Cardiomyopathies: A Need to Identify Indolent Inflammation.

We present 3 cases of inflammatory cardiomyopathies illustrating the need for a multimodality imaging and multidisciplinary approach for diagnosis and treatment. ().

Interoperator reliability of an on-site machine learning-based prototype to estimate CT angiography-derived fractional flow reserve.

Background: Advances in CT and machine learning have enabled on-site non-invasive assessment of fractional flow reserve (FFR).

Purpose: To assess the interoperator and intraoperator variability of coronary CT angiography-derived FFR using a machine learning-based postprocessing prototype.

Materials And Methods: We included 60 symptomatic patients who underwent coronary CT angiography.

Added Prognostic Value of Plaque Burden to Computed Tomography Angiography and Myocardial Perfusion Imaging in Patients with Diabetes.

Background: We aimed to compare the added prognostic value of plaque burden to cardiac computed tomographic angiography (CCTA) anatomic assessment and single-photon emission computed tomography (SPECT) physiologic assessment in patients with diabetes undergoing both tests.

Methods: Consecutive patients with diabetes who underwent clinically indicated CCTA and SPECT myocardial imaging for suspected coronary artery disease were included. Stenosis severity and segment involvement score (SIS) were determined from CCTA, and presence of ischemia was determined from SPECT.

Obstructive Coronary Atherosclerosis in a Patient with a Calcium Score of Zero.

Museum images feature novel multimodality imaging that illuminates the important role of imaging in the diagnosis and management of on unusual cases and conditions. Image files should be accompanied by a contextual description of approximately 100 to 300 words. Videos are welcome, and abstracts are unnecessary.

Prognostic Value of Computed Tomography-Derived Fractional Flow Reserve Comparison With Myocardial Perfusion Imaging.

Objectives: The aim of this study was to compare the incremental prognostic value of coronary computed tomography (CT) angiography (CCTA)-derived machine learning fractional flow reserve CT (ML-FFRct) versus that of ischemia detected on single-photon emission-computed tomography (SPECT) myocardial perfusion imaging (MPI) on incident cardiovascular outcomes.

Background: SPECT MPI and ML-FFRct are noninvasive tools that can assess the hemodynamic significance of coronary atherosclerotic disease.

Methods: We studied a retrospective cohort of consecutive patients who underwent clinically indicated CCTA and SPECT MPI.

Avoidance of ST-Segment-Elevation Myocardial Infarction Treatment for >1 Week Due to COVID-19 Fears.

During the coronavirus disease 2019 (COVID-19) pandemic, social distancing guidelines have negatively affected the care-seeking behavior of patients with chronic medical conditions, including those with cardiovascular disease. We report the case of a 60-year-old man with vague gastrointestinal symptoms who waited more than 1 week to seek treatment for fear of COVID-19 infection. On presentation at another hospital, he was found to have had an anterior myocardial infarction, and he underwent percutaneous coronary intervention to stent an occluded proximal left anterior descending coronary artery.

Added prognostic value of plaque burden to computed tomography angiography and myocardial perfusion imaging.

Background And Aims: Cardiac computed tomographic angiography (CCTA) - derived measures of coronary artery disease (CAD) burden have been shown to independently predict incident cardiovascular events. We aimed to compare the added prognostic value of plaque burden to CCTA anatomic assessment and single photon emission computed tomography (SPECT) physiologic assessment in a cohort with high prevalence of risk factors undergoing both tests.

Methods: Consecutive patients who underwent clinically indicated CCTA and SPECT myocardial imaging for suspected CAD were included.

Passive antipyretic therapy is not as effective as invasive hypothermia for maintaining normothermia after cardiac arrest.

Aim Of The Study: Targeted temperature management is a class I indication in comatose patients after a cardiac arrest. While the literature has primarily focused on innovative methods to achieve target temperatures, pharmacologic therapy has received little attention. We sought to examine whether pharmacologic therapy using antipyretics is effective in maintaining normothermia in post cardiac arrest patients.

The prognostic role of cardiac positron emission tomography imaging in patients with sarcoidosis: A systematic review.

Purpose: Sarcoidosis is a multi-systemic inflammatory disease of unknown etiology. Cardiac sarcoidosis (CS) has been reported in as much as 25% of patients with systemic involvement. Fluorodeoxyglucose (FDG) positron emission tomography (PET) has a high diagnostic sensitivity/specificity in the diagnosis of CS.

Predicting in-hospital mortality after an in-hospital cardiac arrest: A multivariate analysis.

Aim Of The Study: Most survivors of an in-hospital cardiac arrest do not leave the hospital alive, and there is a need for a more patient-centered, holistic approach to the assessment of prognosis after an arrest. We sought to identify pre-, peri-, and post-arrest variables associated with in-hospital mortality amongst survivors of an in-hospital cardiac arrest.

Methods: This was a retrospective cohort study of patients ≥18 years of age who were resuscitated from an in-hospital arrest at our University Medical Center from January 1, 2013 to September 31, 2016.

Diagnosis of cardiac sarcoidosis: a primer for non-imagers.

Sarcoidosis is a multisystem granulomatous disorder that can potentially involve any organ. Cardiac involvement in sarcoidosis has been reported in up to 25% of patients based on autopsy and imaging studies. The gold standard for diagnosing cardiac sarcoidosis is endomyocardial biopsy demonstrating non-caseating granulomas; however, this technique lacks sensitivity due to the patchy nature of myocardial involvement.